Annus Horribilis for ADHD

Annus Horriblis for ‘condition’ in 2013

Never in the field of scientific conflict has an ever increasing ‘many’ so actively opposed the views of the ever dwindling ‘few’ public advocates of the questionable psychiatric diagnosis and medication, as in the case of ADHD, for the Safeguarding of Children and other client groups.

-Dave Traxson

“A terrible year for the ADHD camp and a good year for Safeguarding Children.”-Dave Traxson

In 2013 even some of the ‘few’ changed camps due to the unrelenting exposure of the weakness of their case which has been powerfully put forward for the last thirty years using the now largely discredited and evidence base lacking, ‘chemical imbalance’ explanation of problem behaviours and mental health difficulties.

The most significant, last minute, evacuee from the pro-ADHD task force has been Professor Leon Eisenberg who invented the term ADHD and told a reporter from Der Speigel the German broadsheet just before his death that he regretted his role in identifying this ‘disorder’ and was cited as stating that,

ADHD is a prime example of a fictitious disease.

Leon Eisenberg had made a luxurious living off his “fictitious disease,” thanks to pharmaceutical sales. Coincidentally, he received the Ruane Prize for Child and Adolescent Psychiatry Research. He had been a leader in child psychiatry for more than 40 years through his work in pharmacological trials, research, teaching, and social policy and for his theories of autism and social medicine, according to Psychiatric News, who interviewed him.

Yes, it was even admitted that they were only his theories. In the reporter’s view,

The medical industry is using the guise of helping children to depersonalize and disconnect our children from a healthy, normal upbringing. Parents are placing their children on these drugs and subjecting them to what the psychiatric world has to offer.

The next escapee, trying to dig his way out of the highly guarded and secretive pro-camp was Dr. Keith Conners who produced the commonly used and very lucrative checklist, which is still used worldwide to subjectively ‘diagnose’ ADHD and other conditions. This is often done by professionals who have not triangulated the data, as Conners advised, from school, parents and professionals ,who should have filled in the forms, separately . He responded when he was presented with the latest figures of ADHD diagnosis rates from the Centers for Disease Control and Prevention showing that the diagnosis had been made in 15 percent of high school-age children, and that the number of children on medication for the ‘condition’ had soared from 600,000 in 1990 to 3.5 million now. He questioned the rising rates of diagnosis and called them,

A National disaster of dangerous proportions.

He went on to say interestingly,

The numbers make it look like an epidemic. Well, it’s not. It’s preposterous.

Epidemics are usually more uniform in nature which is not the case with ADHD in the U.S. or Europe. Dr. Conners, a psychologist and professor emeritus at Duke University, said in a subsequent interview,

This is a concoction to justify the giving out of medication at unprecedented and unjustifiable levels.

Another academic has also gone public in a new book on the problems with an ADHD diagnosis, its author Dr. Richard Saul, one of America’s leading neurologists. In an article in the Times newspaper as recent as the January 8, 2014 he asserts ADHD is not a syndrome on its own but a collection of symptoms caused by more than 20 separate conditions — from poor eyesight and giftedness to depression and bipolar disorder — each requiring its own specific treatment. In the United States, where so many millions of people take medication for the condition that there have actually been ADHD-drug shortages, the book has received as frosty a reception as the polar vortex swathing the country in record low temperatures.

So to summarize the results of these recent ‘confessionals’:

– ADHD is not a legitimate epidemic despite its scale.

– Diagnosis levels and resulting medications are dangerous to children.

– ADHD is not a coherent and uniform condition.

– Business models and aggressive marketing are a main reason for this expansionism into childhood.

I could easily ‘rest my case’ there with the views of these prominent deserters. There have been other ‘watershed moments’ though that add weight to the views of those increasing numbers of professionals who support an alternative explanation to the medical model for ADHD and other subjectively diagnosed ‘conditions’ and ‘disorders’. These colleagues who are increasingly ‘putting their heads above the parapets’ risking criticism from medical colleagues and even disciplinary action in some cases have had enough of the risks of harm that psycho-stimulants and psychotropic drugs do to children.

One additional success worthy of note was the landmark class action lawsuit against Johnson and Johnson the multinational pharmaceutical corporation which despite massive resources lost the first case put for criminal injury of young and elderly people for the drug Respirdal. The settlement says it all, which at $2.3 Billion for criminal injury, indicates clearly the U.S. court’s increasing concerns about the escalating levels of harm done to children by psychotropic drugs. In this case the criminal injury was the result of boys developing fully formed breasts and delayed puberty which caused them physical and psychological harm. Other class actions have also been successful that are more directly related to ADHD and there is clear evidence that the rate of these litigious actions for groups is increasing and moving into more serious areas for claims such as criminal injury.Perhaps this will help to put the brakes on the profitable industrial machine which is driving this dubious diagnostic process.

The most extreme side effect from psycho-stimulants is sudden death from heart failure, which between 1990 and 2000, claimed the lives of 186 children from methylphenidate reported to the FDA MedWatch program in America, a voluntary reporting scheme. These numbers represent no more than 10 to 20% of the actual incidence. Just assuming that rate of under-reported deaths continued in 2013 then the 100+ likely deaths reported on death certificates certainly traumatically wrecked 2013 for those affected families in the U.S. and in the U.K. the average is about 2-3 children a year due to our much lower prescription and dosage rates here.

So 2013 is definitely a year to forget for the advocates of ADHD diagnosis, psycho-stimulant medications, and other psychotropic drugs. For the increasing numbers of child mental health workers who are questioning the medical orthodoxy, we have taken much heart from these interconnected happenings. The studies which support the initial use of psychological therapies as the first response to behavioural difficulties, are also positive steps, such as the National Institute of Health (NIH) and Clinical Excellence (NICE) recommending in its guidance on approaches to ADHD intervention. Indeed in 2012 the government of the U.K. made £400 million more available for this purpose which was welcomed by the British Psychological Society, Division of Child and Educational Psychology (DECP) and the Association of Educational Psychologists (AEP).

Let’s hope that 2014 continues this rapid trend of psychiatrists and their friends abandoning ship before the Titanic of the pharmaceutical-medical complex hits the icebergs of ethical practice and public opinion waiting for it in the big pond of life. No longer can pseudo-science and financial inducements overcome ethical, rational and holistic assessments of need.

The financial conflicts of interest in psychiatry, which have biased clinical interventions was best illustrated by American psychologist Lisa Cosgrove and others in their study “Financial Ties between DSM-IV Panel Members and the Pharmaceutical Industry.” In 2007 they found that of the 170 DSM panel members 95 (56 percent ) had one or more financial associations with companies in the pharmaceutical industry. One hundred percent of the members of the panels on ‘Mood Disorders’ and ‘Schizophrenia and Other Psychotic Disorders’ had financial ties to drug companies. This evidence based disclosure led to a Senate Inquiry ably led by Senator Charles Grassley, which caused great embarrassment to the notable individuals involved and led to some being suspended from their academic duties.

To paraphrase a well known quote from Wedgewood Benn, the renowned British parliamentarian about democracy,

The good in people makes progress possible, the evil in people makes progress essential.

Will 2014 maintain this rapid rate of progress to Safeguard Children and other vulnerable groups from the tsunami of psychotropic drugs which was about to engulf us all, damaging not improving our collective quality of life?

I am a Chartered Educational Psychologist (BPS),who has seen the questionable practice of over-diagnosis and prescription of psychotropic drugs for children, increase exponentially in my thirty year career. I am a member of the Division of Educational and Child Psychologists Committee of the British Psychological Society. Now is the time to appropriately challenge doctors in cases where psychologists have ethical concerns about the Emotional Wellbeing of the children with whom they work. This is supported by the Health Professionals Council "Duties as a Registrant."(2009) = "You must not do anything or allow someone else to do something that you may have good reason to believe will put the health or safety of a service user in danger." We all therefore have a "Duty of Care to be Aware" of these issues in the schools where we work and to discuss concerns with a linkworker there and with the prescribing doctor. The National Committees of the Association of Educational Psychologists and the Division of Educational and Child Psychology of the British Psychological Society actively support my position of raising concerns about the impact of psychotropic drugs on the Safeguarding of Children in the U.K. from the potential short and longer term physical and psychological harm. I believe this is a key issue in promoting wellbeing of children within a progressive society. I was pleased to contribute to the BPS response to the American Psychiatric Association's consultation on DSM-5 and the paper was called "The Future of Psychiatric Diagnosis," (BPS 2012.)

3 Comments Already

Thank you for an extraordinarily succinct and sober review of recent developments in the case against presentday treatment of ADHD.

The harm of medications to the brains and bodies of young children is an especially compelling* issue, but misdiagnosis and adverse side effects have existed for many years in all age groups and diagnoses. It’s only now with the growing “epidemic” of overmedication which has reached crisis level that it can no longer be ignored. This is especially true in the USA.

What is the explanation for this epidemic?

There is another growing epidemic–of institutions that ignore malfeasance in their systems.
One of the earliest that came to the public’s attention was the tobacco industry’s decades-long denial of the connection between cancer and tobacco.
The Catholic Church (and other institutions) covering up child sex abuse–and, recently, acquaintance rape in colleges and universities and the US armed forces.
On Wall Street and in transnational finances and business.
And now the pharmaceutical industry that is, as you correctly point out, pushing legal drugs very much like the illegal drug cartels.
It’s long been known that power corrupts and that excessive power (and a loss of feedback systems) leads to extreme corruption.

But there are other issues–and let me mention just one of them.

The letter of response from the American Psychiatrists Assn. (ApA) to the original Petition calling for an independent review of the DSM-5 (and ultimately of the DSM in general) is a dismissive refusal to address any of the concerns raised.
Anyone familiar with institutional cover-ups will recognize the unspoken implications.
Mental health systems have long been used to intimidate and silence whistleblowers. Now a large group of MH professionals are in effect being treated as whistleblowers. For professionals in the field who have spent a lifetime negotiating around the imperfections of MH systems and who have done everything they can to maintain their objectivity (and humanity) as scientists it’s hard to come to terms with this.
What are the possibilities?–Job loss? Damage to professional reputation? Distancing by colleagues afraid to get caught in the mess?

Perhaps you’re less exposed to this in the UK where the insurance and pharmaceutical companies have less influence. (And I’m very happy to hear that overmedication is much less severe in the UK.
But unless you have already struggled with this before in your life, it requires real emotional growth to come to terms with it.

I went through this myself in the process of trying to become independent of an extremely intelligent and well-educated, but equally unhealthy family system.

For over 8 months I’ve been reading the Dxsummit and have recognized the symptoms– that professionals don’t know how to respond when a group of scientists in administrative positions dismissively turns down a call for a scientific review. It is “the unthinkable.”
And so the response is often shock, fear, denial or helplessness.

What works is to hang in there and NOT be intimidated by efforts of intimidation, manipulation or co-opting. Struggle with your fears and doubts but don’t be overcome by them. In the long view, historically, you are in the right. And the lives and futures of millions of patients/counselees around the world depends on a healthier mental health system that is becoming global.

This comment needed to be separate from the above. The problems of diagnosing ADHD are especially complex because it refers to behaviors that are part of normal childhood–such as is the kinesthetic stage of development.
Until the ages of 8-9 children learn best through physically doing things; they are extremely active and wiggley and “can drive the devil bowlegged” as they used to say.
Perhaps television and the passivity it promotes has caused us to lose sight of this reality and we’re expecting them to sit still for hours as they do before a two-dimensional image they can’t interact with physically.
I was growing up before television became common and remember the groups of neighborhood children tearing around, running constantly. Back then parents could tell their children to, “GO OUTSIDE!” even in New York City.
Another part of ADHD may be because so many babies today don’t have a consistent person to bond to who is responsive and caring and not too much in a hurry. The first level of self-regulation comes when a baby in the first months is in distress and they are comforted; when they are angry and someone helps them to calm down. Is ADHD also a crisis of lack of help in developing self-regulation?

Dear Mr. Traxson,
Please add Dr. Gene Arnold of Ohio State University and Dr. Lily Hechtman of McGill in Montreal to your list of ADHD retractors. These psychiatrists admitted that the $11 million study they did in 1998 – “The MultiModal Treatment Study of Children with ADHD” – is flawed and the conclusion that Ritalin was the way to go for children is wrong.

“I hope it didn’t do irreparable damage. The people who pay the price in the end is the kids. That’s the biggest tragedy of this.”
(Dr. Lily Hechtman)

Google “ADHD Experts re-evaluate Study’s Zeal for Drugs” by Alan Schwartz, New York Times